Maxillary sinus cancer arises from malignant transformation of maxillary sinus mucosal epithelial cells. Early symptoms are nonspecific, commonly including unilateral nasal obstruction, facial numbness, and toothache, and are easily mistaken for dental disease or sinusitis.
Maxillary sinus cancer prevalence worldwide
Maxillary sinus cancer accounts for a proportion of head and neck malignancies and is the most common paranasal sinus malignancy. Incidence varies geographically and is associated with prolonged exposure to wood dust, nickel, chromium, and other harmful substances. It is more common in men, usually at ages 40-60.
Maxillary sinus cancer symptoms by stage
1.Early-stage maxillary sinus cancer symptoms
The tumor is confined within the maxillary sinus, with symptoms resembling chronic sinusitis, including unilateral nasal obstruction, small amounts of bloody nasal discharge, and mild facial fullness. These are easily overlooked or misdiagnosed.
2.Intermediate-stage maxillary sinus cancer symptoms
The tumor destroys the sinus wall and invades surrounding structures, causing facial swelling and prominence, persistent toothache and loose teeth, eye protrusion and displacement, tearing, and double vision.
3.Advanced-stage maxillary sinus cancer symptoms
Extensive invasion of the orbit, skull base, and facial skin causes facial deformity, severe pain, difficulty opening the mouth, enlarged cervical lymph nodes, and symptoms of distant metastasis.
When to Seek Medical Attention
Early signs of maxillary sinus cancer include persistent unilateral nasal obstruction, facial swelling and prominence, persistent toothache, and loose teeth. Consult a doctor through "Chat with a Doctor" for early detection. During an online consultation, the doctor will ask about your symptoms and occupational exposure history and guide you toward sinus CT and biopsy.
Maxillary sinus cancer stages
Stage 0 maxillary sinus cancer
Cancer cells are confined to the maxillary sinus mucosal epithelium, representing carcinoma in situ. There are usually no obvious clinical symptoms, although unilateral nasal obstruction and small amounts of bloody nasal discharge may occasionally occur.
Stage I maxillary sinus cancer
The tumor is confined to the maxillary sinus mucosal layer without bone destruction, causing unilateral nasal obstruction, purulent bloody nasal discharge, and mild facial fullness, resembling chronic sinusitis.
Stage II maxillary sinus cancer
The tumor invades the sinus wall bone and extends into the nasal cavity or ethmoid sinus, causing facial numbness, toothache, loose teeth, and worsening nosebleeds.
Stage III maxillary sinus cancer
The tumor invades the orbital floor, sphenoid sinus, or pterygopalatine fossa, causing facial swelling and prominence, eye protrusion, double vision, and restricted mouth opening, with ipsilateral cervical lymph node metastasis.
Stage IV maxillary sinus cancer
The tumor invades the skull base or internal carotid artery, or spreads to the lungs, liver, and bones, causing severe facial deformity, intense pain, and systemic wasting.
Maxillary sinus cancer symptoms in detail
1.Worsening unilateral nasal obstruction
Tumor blockage of the maxillary sinus opening and nasal cavity causes progressively worsening unilateral nasal obstruction, initially intermittent and later persistent, with purulent bloody discharge and reduced smell. Ordinary medication provides little benefit.
2.Facial swelling and prominence
The tumor destroys the anterior or lateral wall and invades facial soft tissue, causing cheek swelling and prominence with red skin. A hard, fixed mass with indistinct borders may be palpable.
3.Toothache and loose teeth
Downward invasion of the alveolar process causes pain, loosening, or loss of ipsilateral upper teeth and is often misdiagnosed as dental disease. Symptoms persist after extraction and the wound does not heal.
4.Eye protrusion and displacement
Upward invasion of the orbital floor causes upward displacement and protrusion of the eye, double vision, and reduced vision, with excessive tearing and aching eye pressure.
5.Facial numbness and pain
Invasion of the infraorbital nerve causes numbness or pain in the ipsilateral cheek, upper lip, and nasal ala. Advanced pain is severe and difficult to relieve with ordinary analgesics.
6.Increased nosebleeds
Ulceration and necrosis of the tumor surface increase nasal bleeding, ranging from blood-stained discharge to heavy bleeding, with foul-smelling purulent secretions suggesting tumor necrosis and infection.
7.Markedly restricted mouth opening
Medial invasion of the pterygopalatine fossa and medial pterygoid muscle, or downward invasion of the chewing muscles, causes difficulty opening the mouth. Severe cases may prevent mouth opening entirely and impair eating.
8.Enlarged cervical lymph nodes
Spread to submandibular and upper cervical lymph nodes produces hard, painless neck lumps that progressively enlarge and are poorly mobile, indicating disease progression.
9.Persistent severe headaches
Invasion of the sinus walls and surrounding nerves causes persistent headaches, usually a distending pain in the face and forehead, which may radiate to the temporal and occipital regions in advanced disease.
Conclusion
Early symptoms of maxillary sinus cancer resemble sinusitis and are easily overlooked. Unilateral nasal obstruction with facial swelling warrants prompt medical evaluation. Avoiding prolonged exposure to harmful substances is an important preventive measure.
